Hole-in-Head (HITH/HLLE)
Pitting or pinhole lesions on the forehead. Usually starts as small dots and progresses to deep cavities. Caused by Hexamita parasite + nutritional deficiency + poor water.
Treatment: API General Cure (metronidazole + praziquantel) for 5 days. Improve diet — add vitamins (Seachem Vitality), reduce stress, large water changes. Severe cases need extended treatment.
Ich
White grain spots covering body and fins. Same parasite as in other freshwater fish.
Treatment: raise temperature to 86°F for 7-10 days, dose Ich-X or API Super Ick Cure. Salt at 1 tsp per gallon.
- ✦Always treat the entire tank, not just the fish.
- ✦Discontinue carbon during medication.
Dropsy
Pinecone scales, bloated belly, lethargy. Same internal infection as in other species.
Low survival once visible. Try Kanaplex + epsom salt in hospital tank. Many keepers euthanize advanced cases.
Fin Rot
Ragged fin edges, sometimes with white or red borders. From poor water or fin injury becoming infected.
Treatment: large water changes, salt, and Furan-2 if severe. Improve water quality root cause.
Internal Parasites
Stringy white feces, weight loss despite eating. Common in fish fed live tubifex worms or feeder fish.
Treatment: API General Cure for 5 days. Repeat after 7 days. Switch to commercial frozen/pellet diet to prevent recurrence.
Prevention
Quarantine all new fish 14 days. Maintain water quality religiously. Vary diet. Avoid live feeder fish entirely. Most flowerhorn diseases trace to one of these failures.